Quantifying Normal Diaphragmatic Motion and Shape and Their Developmental Changes via Dynamic MRI

CHEST pulmonary Pub Date : 2025-03-01 DOI:10.1016/j.chpulm.2024.100115

You Hao PhD , Jayaram K. Udupa PhD , Yubing Tong PhD , Caiyun Wu PhD , Joseph M. McDonough MS , Samantha Gogel BA , Oscar H. Mayer MD , Mostafa Alnoury MD , Patrick J. Cahill MD , Jason B. Anari MD , Drew A. Torigian MD

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Abstract

Background

The diaphragm is a critical structure in respiratory function; however, in vivo quantitative description of its motion available in the literature is limited.

Research Question

How do we quantitatively describe regional hemidiaphragmatic motion and curvature via free-breathing dynamic MRI (dMRI)?

Study Design and Methods

In this prospective cohort study, we gathered dMRI images of 177 healthy children and young adults and segmented hemidiaphragm domes in end-inspiration and end-expiration phases of the constructed 4-dimensional image. We selected 25 points uniformly located on each 3-dimensional (3D) hemidiaphragm surface. Based on the motion and local shape of hemidiaphragm at these points, we computed the velocities and sagittal and coronal curvatures in 13 regions on each hemidiaphragm surface and analyzed the change in these properties with age and sex.

Results

This cohort consisted of 94 female patients (range, 6-20 years; mean ± SD, 12.09 ± 3.73 years) and 83 male patients (range, 6-20 years; mean ± SD, 11.88 ± 3.57 years). We observed the following: velocity range: approximately 2 to approximately 13 mm/s; and curvature range: sagittal: approximately 3 to approximately 27 m⁻¹ and coronal: ∼approximately 6 to approximately 20 m⁻¹. There was no significant difference in velocity between sexes; however, the pattern of change in velocity with age was different for the 2 groups. Strong correlations in velocity were observed between homologous regions of right and left hemidiaphragms. There was no significant difference in curvatures between sexes or change in curvatures with age.

Interpretation

Regional motion/curvature of the 3D diaphragmatic surface can be estimated using free-breathing dMRI. Our analysis sheds light on heretofore unknown matters such as how the pediatric 3D hemidiaphragm motion/shape varies regionally, between right and left hemidiaphragms, between sexes, and with age.

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研究背景膈肌是呼吸功能中的关键结构；然而，文献中对其运动的活体定量描述非常有限。研究问题我们如何通过自由呼吸动态核磁共振成像（dMRI）定量描述半膈的区域运动和曲率？研究设计和方法在这项前瞻性队列研究中，我们收集了 177 名健康儿童和年轻人的 dMRI 图像，并对构建的四维图像的吸气末和呼气末阶段的半膈圆顶进行了分割。我们在每个三维（3D）半膈表面均匀选取了 25 个点。根据这些点上半膈的运动和局部形状，我们计算了每个半膈表面 13 个区域的速度、矢状弯和冠状弯，并分析了这些属性随年龄和性别的变化。结果这组患者包括 94 名女性（年龄范围为 6-20 岁；平均 ± SD，12.09 ± 3.73 岁）和 83 名男性（年龄范围为 6-20 岁；平均 ± SD，11.88 ± 3.57 岁）。我们观察到以下情况：速度范围：约 2 至约 13 mm/s；曲率范围：矢状面：约 3 至约 27 m-1，冠状面：∼约 6 至约 20 m-1。性别间的速度无明显差异，但两组的速度随年龄的变化模式不同。在左右半膈的同源区域之间观察到了强烈的速度相关性。性别间的曲率无明显差异，随着年龄的增长曲率也无明显变化。我们的分析揭示了小儿三维膈肌运动/形状如何随区域、左右半膈、性别和年龄而变化等未知问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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CHEST pulmonary

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